by the author of "The Paramedic Heretic" & "America's Dumbest Doctors"

Monthly Archives: September 2015

“I can tell you that in 30 years, this is by far the most unique sentencing I’ve seen. These types of charges usually merit serious, serious prison time. The recommendation here is 20 years, which you would expect under these circumstances.” (Marc Carlos, San Diego criminal defense attorney)

Dr Jeffrey Joel Abrams: He raped patients and got sent to his room as punishment

In issuing this appalling sentence, Judge Laura Halgren ignored the San Diego County Probation Department recommendation of the standard, 20-year state prison term for similar crimes. The only difference? Well, the sexual pervert in this case is a doctor, and he happens to have some medical problems. Get it?

Raise your hand if any of this sounds . . . well, stupid.

Doctor Jeffrey Joel Abrams, age 68, confessed in court to eight charges of sexual penetration of an unconscious person; three charges of sexual assault and another charge of possession of child pornography, which involved pictures of an 8-year-old girl. Deputy District Attorney Kerry Conway said in a news conference that the typical sentence should have been 25 years in prison.

During the trial, 8 different women testified they were assaulted during medical examinations by Abrams at the Volunteers in Medicine free clinic, over a 4-year time-frame that started in June 2010.

“He used his position as a doctor to lead the victims to believe the inappropriate acts served a professional purpose. It appears his actions were well calculated as some of his victims were Spanish speaking or economically disadvantaged, therefore making them less likely to report the crime.” (San Diego County Probation Report)

And yet some people actually wonder why a Paramedic might become a medical heretic.

“We have 30 ophthalmologists and optometrists ready to testify that the Medicare patients in this fraud case never had wet macular degeneration, nor were they ever treated. Doctor Pon indeed did use a laser on patients, but that he set it at such a low energy-level that no leaking veins were ever sealed.”(Assistant US Attorney Mark Devereaux)

Dr David Ming Pon

In a Jacksonville federal court yesterday an eye doctor was found guilty of an appalling crime: he faked thousands of eye-disease diagnoses, which frightened a stunning number of elderly patients, forcing them to endure years of totally unnecessary laser procedures.

Doctor David Ming Pon, age 57, was convicted in a jury trial on 20 charges of Medicare fraud.

Pon, who owns a million-dollar mansion in the town of Windermere, abused his patients at two different clinics – one in Orlando and the other in Leesburg.

During the trial prosecutors revealed that the criminal physician deliberately lied to patients by telling them they had a serious eye disease that would cause them to become blind – macular degeneration. It then became a simple matter to convince them they would need a long series of laser treatments that were nothing but a scam through which he could bill Medicare. One patient testified that he had undergone laser treatments on his eyes every month for 14 years.

U.S. government prosecutors are now in the process of seizing Pon’s properties in the Orlando area. They believe he has a net worth of more than $12,000,000, including money in Chinese bank accounts.

Pon faces a sentence of 200 years in federal prison at his sentencing hearing next year.

The Veterans Affairs Department has repeatedly ignored whistleblower claims and failed to discipline employees for wrongdoing, and that’s preventing feds from stepping forward when they see misconduct at the agency, Special Counsel Carolyn Lerner wrote in a letter to the White House.

The letter came ahead of a Sept. 22 Senate Homeland Security and Governmental Affairs Committee hearing, which examined VA’s response to whistleblower disclosures.

Lerner, who heads up the Office of Special Counsel, outlines several cases, including that of Katherine Mitchell, a VA doctor who blew the whistle on numerous problems at the Carl T. Hayden VA Medical Center in Phoenix, Arizona.

Mitchell claimed that the Phoenix medical center had no nurses in its emergency department appropriately trained in medical triage. She also said Phoenix medical center nursing supervisors required untrained nurses to triage emergency department patients, resulting in at least 110 cases where patients experienced dangerous delays in care.

The concerns were raised by Mitchell in 2009, but it wasn’t until 2014 after VA’s Office of Medical Inspector found that the lapses were a significant risk to the health and safety of veterans, that the Phoenix VAMC initiated a program to train its nurses and improve staffing, Lerner writes in the letter.

Fixing the problem wasn’t the only thing the VA should have done, she says. The agency should have also held accountable the employees who caused the risks to veterans, according to the letter.

“Despite the confirmed threat to patient safety and the failure to act for five years, the VA has not taken disciplinary action against responsible officials,” Lerner says.

By failing to investigate whistleblower complaints and punish employees for misconduct, the VA is doing more than just ignoring employee wrongdoing.

“The failure to take appropriate disciplinary action, when presented with clear evidence of misconduct, can undermine accountability, impede progress and discourage whistleblowers from coming forward,” Lerner says in the letter.

A Wichita-area MD and his wife were each reissued long prison sentences last week for their convictions in a wealth-building scam that resulted in at least 68 narcotic overdose deaths. The original trial occurred in 2010. At the end of the case, U.S. District Judge Monti Belot said this:

“Even here today, I don’t think you appreciate all the harm you caused. The deaths, addictions, all to get money. If there was any decent medical care, it pales in comparison.”

Doctor Stephen Schneider, now age 62 and his wife, Linda, age 57, pleaded for mercy as the judge reassessed their original sentences. The re-sentencing was necessary because the U.S. Supreme Court had ruled in a similar case last year that a victim’s drug use must be the actual cause of death to impose the harshest punishments on physicians, under the Controlled Substances Act. Because of that ruling, Judge Belot dismissed several of the couple’s original convictions in June.

The judge agreed with the prosecution by once again sentencing the doctor to 30 years in prison and his wife, who functioned as their clinic’s business manager, to 33 years. The same punishment was imposed after the couple was convicted in 2010 of Healthcare Fraud Conspiracy resulting in deaths, Illegal Drug Prescribing, Healthcare Fraud and Money-laundering.

The couple’s clinic in the Wichita suburb of Haysville had seen as many as 2,000 people per month – many already known to law enforcement and other clinics as drug addicts.

How do many MDs see patients? Just like this: walking, talking, pill-popping ATM machines

Schneider and his wife had argued that they helped those in chronic pain and would see up to 100 patients a day. But investigators proved that the doctor spent almost no time with his so-called ‘patients’; did almost no physical assessments; kept inconsistent, or in some cases no medical records. They learned that Schneider was in the habit of leaving pre-signed prescription notes for staff to hand out when he was not even present in the clinic. Many so-called patients told police it was well-known in the community as “the place to go” for easy drugs.

“It is almost impossible for me to overstate the harm that these people caused to their community,” Judge Belot said. “Sure they are sorry here today. But it is what they did then that counts most.”

In the city of Cleveland a federal court has found a heart specialist guilty of ordering unnecessary tests, performing scam procedures and illegally billing insurance payers more than $7,000,000.

Dr Harold Persaud

Doctor Harold Persaud, a resident of Westlake, was convicted last Friday of Healthcare Fraud; 13 charges of lying under oath and another charge of Illegal Financial Transactions. During the trial US. government prosecutors were able to prove that Persaud, a cardiologist, would routinely bill Medicare as well as private insurance companies for far more expensive procedures than were actually done; that he falsified medical stress tests to justify unnecessary heart catheterizations; and worse, that he sent many patients for totally unneeded heart bypass surgeries they didn’t need. Here’s what the FBI had to say about this stethoscope scamster:

Persaud performed nuclear stress tests on patients that were not medically necessary

He knowingly recorded false results of patients’ nuclear stress tests to justify cardiac catheterization procedures that were not medically necessary

Persaud performed cardiac catheterizations on patients at the hospitals and falsely recorded the existence and extent of lesions (blockage) observed during the procedures

He recorded false symptoms in patient records to justify testing and procedures on patients

Persaud inserted cardiac stents in patients who did not have 70 percent or more blockage in the vessel that he stented and who did not have symptoms of blockage

He placed a stent in a stenosed artery that already had a functioning bypass, thus providing no medical benefit and increasing the risk of harm to the patient

He improperly referred patients for coronary artery bypass surgery when there was no medical necessity for such surgery, which benefitted Persaud by increasing the amount of follow-up testing he could perform and bill to Medicare and private insurers

When it comes to the pitfalls of healthcare, your education starts here

So your doctor just told you that you need spinal surgery. If you’re smart, your first response will be this question:

“How much money will you personally make, from the surgical implant manufacturer?”

Because since the early 1990’s, this country has experienced a tidal wave in the proliferation of what are known as Physician Owned Distributorships. Which means it is entirely possible your surgeon gains a measure of wealth by recommending your upcoming operation, and by installing a surgical device he personally profits by sticking it into you.

Physician Owned Distributorships are medical equipment businesses which enable doctors to both invest in and distribute mechanical devices. And because the MD is an investor as well as the implant “distributor” he or she is in a remarkable position to increase income on multiple levels, by recommending as well as “selling” the surgery they perform on you. It is not rocket science to see that being in this position creates perverse financial incentives to perform unnecessary operations – over and over and over.

And the best available data * indicates U.S. physicians perform 7,000 unnecessary operations every single day. They kill a jaw-dropping 250 citizens each week.

Physician Owned Distributorships – PODs – first popped up in California 12 years ago and can now be found nationwide. Nobody seems to know where they all are nor exactly how many exist – because like so many other niches of healthcare, the U.S. government does not regulate them.

However, the Department of Health and Human Services has voiced concerns over PODs, recognizing what is clearly a conflict of interest. One obvious scenario is where physicians receive cash payments after referring patients to hospitals, which purchase the very same hardware those physicians distribute. That is called racketeering, and it is a federal crime.

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“We are very concerned by the use of PODs in the health care industry. It could drive unnecessary services, leading to patients getting care they don’t need. It could ultimately drive up medical costs.” (Troy Barksy, Esq. former Health and Human Services’ Office of General Counsel)

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Feeble Enforcement

In the Twilight Zone called healthcare, PODs function in the foggy areas where laws don’t exist. The Department of Justice is currently investigating a company called Reliance Medical Systems for example, and whether they made illegal payments to 3 dozen doctors. Reliance reports they are no longer owned by physicians as they once were, and claims that its business approach is legal.

One of Reliant’s 35 MDs was Doctor Aria Sabit, who at one time was a spinal surgeon in Ventura California. When the law discovered Sabit was a crook, he moved to Michigan. Federal investigators revealed that Sabit’s rate of spinal device surgeries involving “cage” configured implants increased 400% after he became an investor. Detectives learned also that Sabit was paid $360,000 a year by Reliant as a device “distributor.”

Because of the scrutiny, some national hospital management ccompanies such as Hospital Corporation of America and Tenet, have chosen to avoid using PODs completely, to avoid investigative headaches.

Industry Giants Have Little to Fear

Physician Owned Distributorships are changing the landscape of the spinal-device marketplace. The industry has experienced a stunning growth in sales – from $250,000,000 1994 to $7,000,000,000 in 2010, according to Stan Mendenhall, editor of the Orthopedic Network News. Much of that growth is the direct result of ridiculous markups in surgical hardware.

For example, an “average pedicle screw” — used in spinal surgeries — costs about $60 to make, while the average selling price “is over $1,000,” Mendenhall said.

Historically there have been 5 key manufacturers dominating the spinal hardware business. But as PODs have proliferated, the big-5 market share has dropped from 85% to 65%, according to Orthopedic Network News.

Federal Scrutiny is Weak at Best

Utah Senator Orrin Hatch has been an outspoken critic of PODs and joined four other senators in requesting that the HHS’ Inspector General investigate the distributorships four years ago. The Inspector General issued a report last October which found – surprise, surprise – that PODs were linked to higher rates of spinal surgeries. Who would have thought?

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“Unfortunately my suspicions of physicians using PODs were confirmed. PODs can lead to overuse and unnecessary procedures for patients who really might not need them.” (Senator Orrin Hatch)

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The report’s findings were based on questionnaires submitted to 596 hospitals, 589 of which responded. Investigators also looked at Medicare claims for spinals surgeries, and found the following:

One in five spinal fusion surgeries billed to Medicare in 2012 used POD devices

Spinal fusions doubled at hospitals that used PODS compared with those that did not

Spinal surgeries tripled after hospitals began purchasing from a POD

Surgeries that used POD devices used fewer devices but did not have lower costs

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“Somebody needs to go to jail. because fining doctors isn’t going to do it. Fines are a lot less than what they would make in a year, so why would they care about getting fined?” (Dr. Scott Lederhaus, President of the Association of Medical Ethics and critic of Physician Owned Distributorships)

Occasionally we think it appropriate to tip our cap to the thousands upon thousands of physicians in our nation who aren’t the least bit criminal. In fact, some of these guys and gals have figured ways to be

downright upright without committing any crime at all. They treat their patients with respect; save a few lives and – in their downtime – actually deem to entertain us with some mighty fine poetry.

And God love them. Enjoy these scribblings of scriveners.

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Off to the Annual Convention

Oh, we’re off to a medical meeting

Where there’s never a problem with seating

Except in the bar

Where friends from afar

Are exchanging their annual greeting

Since the IRS didn’t complain

When we held our convention in Spain

We’ll talk antibiotic

In someplace exotic

And not in Des Moines or Fort Wayne

If the lectures get too soporific

We’ll steal off to watch the Pacific

And we’ll toss down a few

Tax deductible too!

In a toast to la vie scientifique

So what if we do run up bills?

For dinner with all of the frills

A fine bill of fare

Will help us prepare

To “improve our professional skills”

So we’re off to the annual convention

Eager to turn our attention

To the holy alliance

Of pleasure and science

And sundries we don’t need to mention

(David Goldblatt, MD, University of Rochester)

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The Urinalysis

Some bring their sample in a jar

Some bring it in a pot

Some bring a sample barely ample

While others bring a lot

Some hide it in a paper bag

Some wrap it like a treasure

Some quite undaunted

Proudly flaunt it

As though it gives them pleasure

Some cork it up so tightly that

It’s quite a chore to spring it

Some let it slosh, almost awash

And some forget to bring it

(Richard Armour PhD, Miami)

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Ode to Room 459

They test your blood by pints and quarts

They fill you up with barium

And watch your blushing innards flip

Like fish in an aquarium

They puncture you like needlepoint

They steal your clothes and drag you

From whatsiscope to whosiscope

They pummel, thump and gag you

For there’s a test for every ill

To help the doctor cure it

But few except the well and strong

Are able to endure it!

(Leonard Reeves MD, Gainesville, Florida)

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Have a terrific weekend, readers, and thank you for your support in buying our books.